Preparing for GYN Surgery at Boston Children’s Hospital

Preparing for surgery can feel overwhelming or scary if you don’t know what to expect. You may have some unanswered questions and worries that make you feel this way. Knowing what to expect will help you feel less nervous and more in control.

Before Your Surgery:

A Day Surgery Unit (DSU) nurse will call you. During your pre-op phone call, the nurse will ask you questions about your health history and give you important pre-op instructions.

If you are 18 or older, the nurse must speak with you directly (or receive verbal permission from you to speak with a parent or legal guardian).

If you are having surgery at the BOSTON (Longwood) location, and you won’t be available by phone, please call the DSU at: 617-355-7921 between the 8:00 and 2:00pm and ask to speak with the nurse covering pre-op calls.

Your doctor or nurse will usually ask that you not have anything to eat after midnight the night before your procedure. This means that you can’t have anything to eat—no food of any kind; not even mints, candy, or chewing gum. After midnight you will not be able to have liquids except for CLEAR liquids. Clear liquids include water, apple juice and CLEAR Gatorade. You may NOT have any type of soda or sparkling water (even if clear). Carbonated beverages (such as gingerale, Sprite®, and sparkling water) are NOT considered clear liquids. You may have CLEAR fluids up to 3 hours before your scheduled surgery time. Having an empty stomach before surgery decreases the risks of anesthesia, so it’s very important to follow this rule.

You can brush your teeth in the morning, but don’t swallow any water after rinsing your mouth. If you forget and eat or drink before your surgery, be sure to let the nurse or doctor know right away. If you forget and eat or drink, your surgery will be rescheduled.

If you take prescription medicine, ask your doctor if you should take your medicine with a tiny sip of water. Most of the time, you will be told to wait until after your surgery.

I’m having day surgery—what will happen on the day of my procedure?

The following information is general and is meant to help you get an idea of what might happen on the day of your surgery.

Time to arrive—The time is confirmed by the hospital the day before your scheduled surgery (or a Friday before a Monday surgery). If you are having day surgery, a nurse from the day surgery unit (DSU) will call you between 3pm and 5pm the day before your surgery. If you miss this phone call, please call the DSU at: 617-355-7921 (Boston) or 781-216-1285 (Waltham) to confirm your hospital arrival time. The hospital arrival time is 1.5 hours before the procedure. Both you and your parent(s) or guardian(s) will need to sign consent forms (documents that gives the doctor permission to do the surgery and for anesthesia). Sometimes the consent forms are signed before the day of your surgery.

ID Bracelet—When you check into the hospital, you will be given a plastic bracelet that will have your name and your hospital identification number printed on it.

Day Surgery Area—After you have checked in with the Admissions Department, you will go to the Day Surgery Area, where you will be assigned a nurse who will take your blood pressure and ask you questions such as if you had anything to eat or drink before arriving to the hospital. He or she will probably ask you some private questions about your lifestyle, such as whether or not there’s a chance you may be pregnant, or if you use drugs or alcohol. You should answer these questions truthfully, because the doctors, surgeons, anesthesiologists and nurses need to know if there’s anything they should look out for that may complicate your surgery.

Urine Test— A routine urine pregnancy test is done on everyone of childbearing age, even if you are not sexually active. If there is a chance you could be pregnant, it is VERY IMPORTANT to let your doctor know!

Nail Polish—Please remove your nail polish BEFORE coming to the hospital. If you are wearing nail polish and haven’t removed it yet, you will be given nail polish remover to take it off. This is done because the doctors/nurses need to be able to see your natural finger nail to check your circulation. Nail polish may also get in the way of the pulse oximeter, which is a small machine that gently clips onto your finger to keep track of your pulse.

Acrylic nails—You will need to remove at least 2 acrylic nails (one on each hand) so that your finger pulse can be checked.

Jewelry and Piercings—All jewelry should be removed and left at home before you go to the hospital. By doing this ahead of time, you won’t be worried about losing it. All jewelry will need to be removed, especially nose, lip, and belly button rings, before your surgery.

Makeup and Hair Products—Don’t wear any makeup to the hospital. Small particles of makeup (especially mascara) can get into your eyes during surgery and can cause damage because you don’t have a blink reflex while under anesthesia. Also, makeup, hair products and nail polish can be flammable and should not be worn when you are having surgery.

Clothing—While you are a patient in the hospital, your clothes will be placed in a bag with your name on it. You will be given a hospital gown to wear during the operation and while you are recovering. When you are ready to be discharged from the hospital, you will be able to change back into your own clothes. It is a good idea to wear clothing that is not too tight in the waist so that you are comfortable on the way home.

Your name, date of birth, and the planned procedure will be reviewed with you and your parent(s)/guardian(s) many times while you are in the day surgery area. The medical staff knows who you are, but these are safety checks to make sure that your surgeon always performs the right operation on the right person.

What’s the “pre-op holding area” and what happens there?

The “pre-op” holding area is where you stay before you go to the operating room. While you are waiting to go into the operating room, an anesthesia care provider or IV nurse will likely start and IV. This is a plastic tube that delivers certain medicine to your body during the surgery. It is inserted with a needle, but then the needle is removed so that only the plastic tube remains. The IV is usually placed in your hand. You will receive medicine through your IV to make you feel relaxed. If the anesthesiologist gives you a choice of which hand to put the IV in, choose the hand you don’t write with.

What if I’m afraid of needles?

If the thought of having an IV is upsetting to you, please let your nurse know as soon as possible. You may be able to have a numbing cream placed on your hand which will numb the skin and lower the feeling of pain, so you will have very little (if any) discomfort when the IV is inserted. The numbing cream takes time to work, so it’s important to ask for it as soon as possible. Another option is a “J tip.” This places numbing medicine under your skin. Your skin is numbed right away. When your anesthesia care provider or nurse starts your IV, try to stay as relaxed as possible. You can do this by taking slow, deep breaths, concentrating on something pleasant, or having your parent(s) or guardian(s) distract you with conversation.

Remember, once the IV is started, the needle comes out and all that remains is a tiny plastic tube. When your surgeon feels you are taking fluids well after your surgery (and you are ready to go home), the plastic tube will be removed.

What happens in the operating room?

When you are taken to the operating room, both your name and the procedure (that you are scheduled to have) will be reviewed again. your surgical team will help you get settled in the operating room. They will put a monitor on your finger, a blood pressure cuff on your arm, and three small, sticky pads will be placed on your chest. These will be attached to a heart monitor so that your heartbeat can be seen on a small screen. If you have an IV, you will be given more medicine through your IV that will make you feel very sleepy. You will drift off to sleep and you will stay asleep during your surgery. When your surgery is over, your anesthesia care provider will give you medicine to wake up. You will wake up in the recovery room, and the surgery will be over. It will seem as if you were asleep for only a few minutes.

What is anesthesia?

Anesthesia is the medicine that puts you to sleep and makes you feel no pain during your surgery. There are two different types of anesthesia: “local” and “general.”

Local anesthesia is special numbing medicine that is applied only to the area of your body where you are having a procedure. You are awake during the procedure. Sometimes you might also have an IV so you can be given medicine to help you relax. With this medicine, you may get drowsy, or even fall into a “light” sleep.

General anesthesia puts you completely asleep during your procedure. This type of sleep is a “deep” sleep; you are sleeping so soundly that your anesthesia care provider helps you breathe. With this type of anesthesia, most people wake up feeling sleepy when the surgery is over. The anesthesia will take a while to wear off. In the meantime, you will stay in the recovery room where you will be cared for until you are completely awake and alert.

If you have any worries or concerns about the type of anesthesia that you will be receiving, talk to your nurse. Also, it’s very important to let your surgeon and anesthesiologist know if you or any family members have ever had problems with anesthesia in the past, such as a severe headache, nausea, or a very sleepy feeling that took a long time to wear off. Unless you require emergency surgery, you should know which type of anesthesia you’re going to have in advance.

What happens after surgery?

After your surgery you will be taken to the recovery room. There, your nurse will check on you often, and take your blood pressure, temperature, and pulse, and give you any medicine that your doctor orders. It’s common to feel cold or chilly after surgery. Don’t be shy—ask your nurse for a warm blanket. If you’re thirsty and your doctor has said that it’s okay to have something to drink, your nurse will offer you a clear liquid. Before you can go home, you will need to pass urine (pee). Your nurse will offer you a bedpan or take you to the bathroom. After a little while, when you are fully awake and comfortable, your nurse will help you get ready to go home. You will probably have your IV removed at this time.

Will I have a scar?

Whether you will have a small, medium, long, or no scar at all depends on if your doctor needs to make an incision (a cut in your skin). Some surgical procedures can be done without any cuts while other types of surgeries require your surgeon to cut the skin.

If I have an incision, how long will it take to heal?

Most incisions (where the skin was cut) appear red after the stitches are removed, or dissolve. Dissolving stitches get absorbed by your body and do not need to be removed. About 4-6 weeks after the surgery, the scar from your incision should be much lighter than it was after the operation, but it takes up to a year for it to heal completely. It is very important to keep your incision site out of the direct sun for a year, as direct sunlight may increase scarring. If you must be out in the sun, be sure to use a sunscreen with a high (30+) SPF (sun protection factor) on the healed incision area. With proper care, most incisions heal well. Rarely, people develop a thicker type of scar that has extra fibrous tissue. This is called a keloid scar.

The most important thing to remember if you have an incision is to keep it clean. If you have an incision with stitches, you will receive instructions when you are discharged. The instructions will be specific to the type of surgery that you’ve had.

In general, you should call your doctor if you have:

A temperature of 101 or over

Any blood or drainage from your incision after the first 24 hours

Redness at the incision area

A bad odor coming from the incision

Severe pain in or around the incision

You will most likely be scheduled for a follow-up appointment with your surgeon so that he/she can check to see if you are healing well. It is important to keep this appointment even if you feel terrific.

What should I bring to the hospital?

Since you are having day surgery, you really don’t need to bring very much with you. Most people wear the same clothes home that they wore to the hospital.

What if I get bored while I’m in the hospital?

You probably will be on your way home before you know it—in less than 4 hours, but if you think you might get bored while you are waiting, you can bring a book to read or music to listen to just in case.

What should I do about the school work I’ll miss?

Helpful Tips:

If your surgery isn’t an emergency and your surgeon is available, it might be possible to schedule your procedure during a school vacation week, or during the summer. That way you won’t be worried about missing any school.

If your surgery is scheduled during school time, you can ask your teacher(s) about getting homework assignments ahead of time. Try to get as much of your work done before your surgery without getting too stressed out. Teachers will usually understand your situation if you take the time to explain that you will be having surgery and you may be home recovering for a few days.

If your surgery is an emergency, ask a parent/guardian or friend to get your school work for you. Many teachers will give you some extra time to make up your assignments. You shouldn’t have to worry. If a teacher seems too demanding, speak with your guidance counselor or principal when you return to school.

Ask your doctor or a nurse for a note to excuse your school absences for your surgery and recovery time at home.

If your surgery is on a Wednesday, you can usually return to school on following Monday. Otherwise, your doctor will explain how long you’ll need to stay at home.

What if I have my period while I’m in the hospital?

Don’t worry – It’s okay if you have your period the day of your surgery or while you are in the hospital! This will not cause your surgery to be cancelled.

Most likely you won’t be allowed to wear a tampon while in surgery. Instead, you will be given a pad to wear. The nurse in the operating room will change your pad while you are sleeping if necessary.

What if I’m still nervous on the day of my surgery?

It’s completely normal to feel a bit nervous, but knowing what to expect will make you feel less afraid. Try not to worry too much. Your health care providers and nurses are there to answer any questions you may have. They will take good care of you and keep you comfortable while you are in the hospital. If possible, try to talk with someone else who has had the same procedure that you’re going to have. This may be a friend, relative, or someone your doctor or nurse arranges for you to talk to.

Once you are home recovering from your surgery, it’s important to rest, drink water and other fluids, eat healthy foods, and take care of your incision (if you have one). Our bodies are amazing, but everyone needs time to recover after surgery. Ask your doctor exactly what you can and can’t do so that your recovery is fast and without complications. Remember to talk with your medical team to learn more about specific instructions.

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The Center for Young Women’s Health (CYWH) is a collaboration between the Division of Adolescent and Young Adult Medicine and the Division of Gynecology at Boston Children’s
Hospital. The Center is an educational entity that exists to provide teen girls and young women with carefully researched health information, health education programs, and conferences.